ABSTRACT
BACKGROUND: Children and adolescents with atopic disease who have allergic asthma and/or rhinitis with and without atopic dermatitis may have hidden, clinically relevant contact allergies. OBJECTIVE: The objective of this study was to survey contact allergies in children and adolescents who had been offered allergen-specific immunotherapy and accepted (exposed)/not accepted (unexposed) such treatment. METHODS: Thirty-seven exposed and 24 unexposed individuals with atopic disease were patch tested with a standard series supplemented with aluminum chloride hexahydrate, an empty Finn Chamber, and 8 antigen preparations. RESULTS: In the exposed group, 18 allergies were detected in 13 individuals with atopic disease when excluding reactions to aluminum and antigen preparations, whereas the corresponding figures for the unexposed group were 9 and 6, respectively (non-significant difference). Independent of the allergen-specific immunotherapy, significantly more (P = 0.013) individuals with atopic dermatitis had at least 1 contact allergy. Clinically relevant allergies were represented by sesquiterpene lactone mix, para-tertiary butylphenol-formaldehyde resin, tixocortol pivalate, and colophony. CONCLUSIONS: Clinically relevant contact allergies are not uncommon in children and adolescents with atopic disease, which is why patch testing always should be considered in the management of dermatitis in individuals with atopic disease.
Subject(s)
Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Hypersensitivity, Immediate/diagnosis , Hypersensitivity, Immediate/epidemiology , Severity of Illness Index , Adolescent , Allergens/administration & dosage , Asthma/epidemiology , Child , Comorbidity , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/epidemiology , Female , Germany/epidemiology , Humans , Male , Patch Tests/statistics & numerical data , Rhinitis, Allergic, Perennial/diagnosis , Rhinitis, Allergic, Perennial/epidemiology , Rhinitis, Allergic, Seasonal/diagnosis , Rhinitis, Allergic, Seasonal/epidemiology , Risk AssessmentABSTRACT
BACKGROUND: The development of persistent itchy nodules at the injection site following hyposensitization therapy with aluminium-precipitated antigen extract has been described in several reports. Occasionally, contact allergy to aluminium has been reported in individuals with such nodules. OBJECTIVES: To investigate if hyposensitization therapy can induce contact allergy to aluminium and examine if there is any association between persistent subcutaneous nodules and aluminium allergy. PATIENTS/METHODS: Sixty-one children with allergic asthma and/or allergic rhinitis participated in the study of whom 37 had had hyposensitization therapy. The study consisted of a non-clinical part based on a questionnaire and a clinical part with a physical examination, self-assessment of itching, and patch testing. To secure an unbiased evaluation of possible reactions, the investigators were blinded. RESULTS: Contact allergy to aluminium was found in eight participants, all in the exposed group (8/37 versus 0/24, P = 0.02). Examination showed nodules on the upper arms in 13 participants, all in the group exposed to hyposensitization therapy. Nodules were over-represented in patients with contact allergy to aluminium. CONCLUSIONS: There was a statistically significant association between contact allergy to aluminium and persistent subcutaneous nodules in children who had had hyposensitization therapy.
